The much-awaited ICER (Institute for Clinical and Economic Review) Final Report for myeloma relapse therapies, issued on June 9th, is very tentative and less of a report than an admission that they do not have the expertise to adequately assess the complexities of new myeloma therapies. Functioning under a microscope for the last few months, ICER concedes in a statement at the end of the report that a “Fail First” policy is a mistake for myeloma patients. They have also indicated that they have come to understand that each patient is unique and different and that all therapies will be required during the course of multiple relapses. Also, a system which favors use of panobinostat (an HDAC inhibitor with limited efficacy) over daratumumab (an anti-CD38 antibody with 30% activity as a single agent in relapse refractory disease) is clearly flawed.
ICER, in essence, defers to the expertise of doctors who work with myeloma therapies every day and the experience of patients who have expressed both their needs and their views as impassioned advocates for all patients. It can now be hoped that payers such as CMS/Medicare will not seek ICER guidance.
About the Author
By: Dr. Brian Durie | International Myeloma Foundation (IMF)